Comparative methods of repairing left ventricular aneurysms.
Between 1 March 1992 and 31 June 1996, we enrolled 72 patients with left ventricular aneurysms in a prospective, nonrandomized study to compare--by study of cardiac indices, single-plane ejection fractions, and nuclear ventriculograms--the effects of classical aneurysmectomy (group 1, n = 36) with those of endoaneurysmorrhaphy (group 2, n = 36). Preoperative and postoperative cardiac index measurements were, respectively, 1.96 +/- 0.6 and 3.51 +/- 0.53 for group 1, and 1.96 +/- 0.31 and 3.43 +/- 0.41 for group 2. In this regard, there was not any significant difference between the groups preoperatively or postoperatively. Preoperative and postoperative multiple-gated acquisition measurements, were, respectively, 34.3 +/- 7.76 and 43.1 +/- 11.1 for group 1, and 37 +/- 3.88 and 66.5 +/- 5.2 for group 2. Although there was not any significant preoperative difference between the groups (P = 0.34), group 2 had significant postoperative improvement in left ventricular ejection fractions (P < 0.001). Preoperative and postoperative single-plane contrast ventriculographic ejection fractions were, respectively, 43.4 +/- 8.7 and 48.6 +/- 11.2 for group 1, and 43.8 +/- 5.5 and 60.8 +/- 15.1 for group 2. Again, there was not any significant difference between the 2 groups in preoperative left ventricular ejection fractions (P = 0.87), but the postoperative left ventricular ejection fractions of group 2 were significantly better than those of group 1 (P = 0.022). We conclude that left ventricular functional improvement with endoaneurysmorrhaphy is superior to that with classical aneurysmectomy.
Türkay
C
C
Departments of Anesthesiology, Akdeniz University Medical School, Antalya, Turkey.
Mete
A
A
Yilmaz
M
M
Celik
B
B
Kumbasar
D
D
Sancaktar
O
O
Aydoğdu
T
T
Bayezid
O
O
D002302:Cardiac Output; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging; D006322:Heart Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology